Horowitz: Obamacare - Here to Stay and on the Right Track

This past Thursday morning, there was an unusual substitute for press secretary Jay Carney at the daily White House news briefing—the President himself. President Obama took the podium to highlight the fact that sign-ups on health exchanges for Obamacare ended up exceeding 8 million, more than a million over the well- publicized 7 million CBO estimate and far beyond the predictions of various Republican and Conservative premature gravediggers.

The success of this first period of open enrollment, which ended April 1, came despite the initial serious difficulties with the website and aggressive and well-funded efforts to dissuade people from signing up. According to the White House, other features of the Affordable Care Act have resulted in health care coverage for an additional 6 million people and counting: 3 million young adultswho can now stay on their parents' plan until they are 26; and 3 million more people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Since one can enroll at any point during the year for these programs, the numbers will continue to increase.

Further, 28% of the people who purchased private insurance through the exchanges are between the ages of 18 and 34. This is substantially lower than their 40% share of the population, but in line with insurance company estimates and comparable to the first year of the successful Massachusetts program. Boding well for keeping down increases in premiums in future years, 5 million more people are now enrolled in plans that meet Affordable Care Act standards outside the exchanges. By the requirements of the new law, this additional pool of people must be factored in when insurance companies set premiums for next year..

The Congressional Budget Office (CBO) now estimates that twelve million more people will have health insurance in 2014 due to the new law. This is a factual rejoinder to the repeated arguments by conservatives that the number of net new people insured was going to be slight or non-existent due to people losing their existing insurance policies because they did not meet the requirements of the Affordable Care Act.

It will take a while for public opinion to catch up with Obamacare’s success. While there has been a significant improvement in approval for the law since its low water mark just after the disastrous role out of the federal website, it remains unpopular. And it is particularly unpopular with the older and white voters that make up a disproportionate share of the electorate in Congressional mid-term elections.

The long-term picture, however, looks quite favorable. As with any comprehensive reform, tweaks and changes are needed. But over-all, it is working as envisioned, providing access to quality health care to many more Americans and assisting in putting the breaks on health care costs. It is a consequential accomplishment—one worth all the extensive political capital the President has spent and continues to spend on it.

Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island.

Related Slideshow: Preventable Deaths in American Hospitals

To Err is Human

In 1999 the Institute of Medicine published the bombshell “To Err Is Human” report, which revealed that up to 98,000 people a year die because of mistakes in hospitals. Though initially disputed, the report is now widely accepted by doctors and hospital officials, including RI Dept. of Health Director Dr. Michael Fine.

Health and Human Services

Journal of Patient Safety

In 2013, the Journal of Patient Safety published research that claims the number of preventable deaths may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death. That's roughly one-sixth of all deaths in the United States each year.

John. T. James, Ph.D

Based on that 2013 Journal of Patient Safety report by John T. James, Ph.D, medical errors are the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

Over Treatment

Many preventable deaths are the result of "over treatment," according to Dr. Michael Fine, Director of the Rhode Island Department of Health, who said 30 to 50 percent of all medical procedures are unnecessary.